In every other advanced nation, insurance coverage is available to everyone regardless of medical history. Our system is unique in its cruelty.
So what’s the answer? Americans overwhelmingly favor guaranteeing coverage to those with pre-existing conditions — but you can’t do that without pursuing broad-based reform. To make insurance affordable, you have to keep currently healthy people in the risk pool, which means requiring that everyone or almost everyone buy coverage. You can’t do that without financial aid to lower-income Americans so that they can pay the premiums. So you end up with a tripartite policy: elimination of medical discrimination, mandated coverage, and premium subsidies.
Or to put it another way, you end up with something like the health care plan Mitt Romney introduced in Massachusetts in 2006, and the very similar plan the House either will or won’t pass in the next few days.
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